A Clinical Analysis of Pre-operative Tranexamic Acid and Wound Closure without Suction Drain in Decreasing the Blood Loss in Surgical Treatment of Fractures of Hip
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 2
Abstract
Background: Fractures of the hip region are very common in the elderly population and include fracture neck of femur, intertrochanteric fractures, and subtrochanteric fractures. All of these are routinely treated by surgery to make the patient ambulant early. Most of these elderly people are anemic with poor blood reserve, and many of them need pre-operative blood transfusion to improve their hemoglobin concentration to make them fit for surgery. Hence, an additional blood loss during surgery and in the immediate post-operative period is to be avoided as much as possible. A common practice is to use suction drains in fracture surgery to decrease the incidence of post-operative blood collection (hematoma inside the wound). Tranexamic acid is a drug which reduces blood loss during surgery and post-operative period. Materials and Methods: Kindly provide text part: A total of 210 patients with fracture hip joint were divided into three groups of 70 each. Group A consisted of patients with fracture hip joint undergoing surgery, treated pre-operatively with tranexamic acid but no suction drain. Group B consisted of patients with fracture hip joint undergoing surgery in which only suction drain was used (no tranexamic acid). Group C consisted of patients with fracture hip joint undergoing surgery without tranexamic acid and suction drain. Both pre-operative and post-operative hemoglobin concentration estimations were done. All surgeries were done under epidural/spinal anaesthesia. In Group A, tranexamic acid intravenous (I.V.) injection of tranexamic acid 1 g was given 10 min before incision and repeated as 500 mg I.V after 6 h in the post-operative period. The post-operative hemoglobin was compared with pre-operative hemoglobin value. Conclusions: It was found that average fall of hemoglobin in the group with pre-operative intravenous tranexamic acid with drain less wound closure was less compared to other groups and to known standard loss after hip surgery.
Authors and Affiliations
Sathis Chandran, Sasikumar Sasidharan
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